Guide to the Surrogacy Process – The 7 Steps of Surrogacy

By Babygest Staff
Last Update: 07/05/2019

Surrogacy is probably the most challenging process of all fertility treatments, but also the most rewarding one for the parties involved. Educating yourself on how the process works, as well as being aware of everything you need is the secret to having a pleasant and successful journey.

Before summarizing the basic steps of every surrogacy journey in this step-by-step guide, you should keep in mind that some details, especially the legal requirements, may vary from state to state.

The surrogacy decision

Before beginning the surrogacy journey, whether you are an opposite-sex couple, gay couple, or a single person, you should educate yourself on the basics of this fertility option and find out if you are fully committed to this process.

Surrogacy can be a fulfilling experience as it means that a new family member is about to arrive, but at the same time it requires time, patience, and commitment. It should be clear that you won't be able to make major travel plans or plan intense activities during that time period.

Also, surrogacy requires a great financial and emotional investment in equal proportion. If you have decided to become parents through surrogacy, the first step is to consult a surrogacy agency, counselor or attorney who specializes in surrogacy arrangements.

Initial consultation

Once you have made up your mind and want to continue with the surrogacy journey, you must determine your goals, expectations, and the professionals you are willing to work with. Basically, the first step is to look for an agency and an attorney:

Surrogacy agency
They provide part or all the surrogacy services, including the surrogate matching process, support counseling, case management...
Surrogacy attorney
Surrogacy is a fertility treatment in which a great deal of legalities are involved. The work of an attorney is required to complete the legal work (contracts, birth order, legal parentage, etc.).

Most agencies offer hopeful intended parents a first free consultation to get to know each other, learn about the programs available, and find out about the financial options.

At this stage, you will also decide about basic aspects, including whether you need donor sperm and/or eggs, whether you know the surrogate or need matching services.

Selection of an egg donor

If the intended mother cannot use her own egg cells for the creation of the embryo(s), it is necessary to use donor eggs. Typically, egg donors are young, healthy girls between the ages of 21 and 29.

Although many commissioning parents bring their own egg donor, whether she is a family member or close friend, many clinics or agencies have egg donor databases that allow you to browse for the most adequate woman.

For a candidate to be eligible, they have to pass a thorough medical screening that confirms that they are healthy. Their medical records should be reviewed by a reproductive endocrinologist before being accepted into the donor program.

Selection of a surrogate

For most intended parents, the most rewarding and exciting step of their surrogacy journey is finding the right surrogate for them. Unless it is a friend or family member, this step will require more or less time.

Surrogates are generally women aged 21-41 years who have undergone a mental health and medical screening test before being matched. Their criminal and financial records are checked as well.

When prospective intended parents or surrogates apply for finding a surrogacy opportunity at an agency, the professionals at the center create a profile.

Then, when the time to make a match comes, they will try to match you with a surrogate whose surrogacy plan is similar to yours. And they will do the same with the other party.

Don't forget that, for a match to be effectively done, both parties must agree to working with each other.

The process will continue only if both parties agree to move forward together. In that case, the first step would be getting to know each other better, either through phone calls, emails or even in-person meetings.

If everything is okay, they must sign an initial legal contract in order to make the match oficial.

Making the matching official by drafting a contract is crucial in every surrogacy arrangement. When taking this step, each party will have their own attorney to ensure that the legal interests and rights of both are protected.

It is required that each party agrees to the terms of the contract and has signed it before beginning the embryo transfer process. To this end, each party will review the terms of the contract carefully beforehand:

Compensation, possible risks, rights and obligations, what to do in case of unexpected events, abortion rights, etc. Prospective gestational carriers should keep a close eye on these terms.
Intended parents
Making your legal rights clear, including how to manage potential risks and establishing the compensation that you will pay to your surrogate is crucial.

Only if both parties agree to the terms and conditions described on the contract and sign it, you will be able to start the medical process, a phase in which you will work closely with the fertility clinic you agreed upon at the beginning.

Medical process step by step

Once the legal contract is signed, the medical procedure can be started. At this stage, two steps are crucial—fertilization and embryo transfer. We should not forget that the ultimate goal is that the surrogate gets pregnant successfully.

The fertility treatment used nowadays in gestational surrogacy procedures is In Vitro Fertilization (IVF). Intrauterine Insemination (IUI) has fallen into disuse due to the added complications involved in traditional surrogacy arrangements.

IVF surrogacy works as any other traditional IVF procedure. Ideally, the eggs and sperm of the intended parents are used to create the embryo. Finally, the embryo or embryos are transferred to the uterus of the surrogate.

Both the intended mother—or the egg donor in case she cannot use her own eggs—and the gestational carrier have to take medications before the embryo transfer, each for a different purpose:

  • Intended mother/egg donor: To stimulate the ovaries for the production of multiple eggs. Once mature, they will be collected through follicle puncture (ovum pick-up).
  • Gestational carrier: To prepare the endometrium for it to be receptive at the moment of the embryo transfer.

The surrogate will take a pregnancy test about 15 days before the transfer. Normally, surrogates start receiving their compensation in installments, monthly allowance, and prenatal care once the fetal heartbeat has been confirmed by ultrasound.

During the pregnancy, surrogates have to visit the clinic on a regular basis for blood tests and ultrasounds in order to check if everything is progressing as expected. If you agree so with the IPs, you can share your pregnancy journey with them.

Pregnancy & birth

When the desired pregnancy is achieved, it is your program coordinator's job to support both you and your surrogate and to prepare you for the birth of your child. Normally, intended parents wish to join the surrogate at the hospital experience it first hand.

Once the baby is born, it is crucial that you pay attention to all the necessary documents that you must complete and file to ensure that parental rights are properly established. It is your attorney's responsibility to secure proper court orders, passports, legal documentation...

Aside from not being legal in all 50 states, regulations may vary from state to state. Learn more about it here: Surrogacy in the USA.

Intended parents living outside the United States have to ensure that every legal document required in their home country is properly filed. Checking what are the requirements in your departure country to register the birth of a child born abroad is a key step to a successful surrogacy journey.

When everything has finished, it is common among surrogates and intended parents to remain connected over the years and maintain a close relationship during the child's life. Surrogacy agencies often facilitate the building of this relationship to create a comfortable environment between the parties.

FAQs from users

What are the main steps of gestational surrogacy?

By Dr. Joel G. Brasch (gynecologist).

Medical screening of the IPs, choosing an egg/sperm donor (if applicable), embryo creation, surrogate matching, medical screening of the GC (and GC’s partner), legal clearance, embryo transfer, pregnancy, birth & documentation, and then return home.

How long does the surrogacy process take?

By Natalia Álvarez (project manager).

Actually, it varies on a case-by-case basis, but typically it takes 1-3 months to become matched with a surrogate, and another 1-3 months to complete the legal process. Then, the surrogate is on medications to prepare for the embryo transfer for 3-4 weeks. After that, we should add the 9 months of pregnancy plus the time frame that is necessary for all legalities to become the legal parents to be properly completed.

How much does a surrogate procedure cost?

By Natalia Álvarez (project manager).

The cost of a surrogacy procedure ranges between $90,000 and $130,000 on average but, again, it varies depending on the case and the needs of each IPs. Get more info: Surrogacy Cost Breakdown.

Suggested for you

Did you know that, in spite of the common belief that surrogacy arrangements are fully legal in the USA, actually not all 50 states allow it. In case you want to get an idea of how does it work in the different US states, click here: Surrogacy in the USA – Is It Legal in All 50 States?

As you may have seen, surrogacy is a challenging procedure for all the parties involved: many steps are involved, including a complex legal process. This explains all the costs that are involved. To help you create your own budget in case you're considering becoming parents via surrogacy, check this out: Surrogacy Cost Breakdown – Agency & Gestational Carrier Fees.

Finally, check this guide for hopeful intended parents who are still in the process to making up their minds on whether they want to have a child via surrogate or not. Here's everything you need to know: Parents through Surrogacy Guide – The Process Step by Step.

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